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非侵入性脑刺激对阿尔茨海默病的影响。

Effects of Non-Invasive Brain Stimulation on Alzheimer's Disease.

机构信息

Lihua Gu, PhD, Department of Neurology, Affiliated ZhongDa Hospital, Medical School, Southeast University, No. 87 Dingjiaqiao Road, Nanjing, Jiangsu, China, 210009, Tel: 0086-25-83262241, Fax: 0086-25-83285132, E-mail:

出版信息

J Prev Alzheimers Dis. 2022;9(3):410-424. doi: 10.14283/jpad.2022.40.

Abstract

BACKGROUND

Previous meta-analyses did not explore the immediate and long-term effect of non-invasive brain stimulation (NIBS) on different cognitive domains in Alzheimer's disease (AD). The meta-analysis aimed to assess the therapy effect of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on different cognitive domains in AD in randomized controlled trials (RCTs).

METHODS

Studies published before December 2021 and exploring therapy effect of rTMS, tDCS on different cognitive domains in AD were searched in the following databases: PubMed and Web of Science. We used STATA 12.0 software to compute the standard mean difference (SMD) and a 95% confidence interval (CI).

RESULTS

The present study included 16 articles (including 372 AD patients treated with rTMS and 310 treated with sham rTMS) for rTMS and 11 articles (including 152 AD patients treated with tDCS and 134 treated with sham tDCS) for tDCS. The present study showed better immediate and long-term general cognitive function increase effects in AD given rTMS, compared to those given sham rTMS with random effects models (immediate effect: SMD = 2.07, 95% CI = 0.37 to 3.77, I2 = 97.8%, p < 0.001; long-term effect: SMD = 5.04, 95% CI = 2.25 to 7.84, I2 = 97.8%, p < 0.001). The present study showed no significant immediate and long-term effects of rTMS on attention, executive, language and memory functions. In addition, the present study showed no significant difference in immediate or long-term effects of tDCS on general cognitive function, attention, language or memory functions between tDCS group and sham tDCS group.

CONCLUSIONS

RTMS was an effective treatment technique for general cognitive function in AD, whereas tDCS showed no significant therapy effect on cognitive function in AD. More large-scale studies were essential to explore the effect of NIBS on various cognitive function in AD.

摘要

背景

先前的荟萃分析并未探讨非侵入性脑刺激(NIBS)对阿尔茨海默病(AD)不同认知领域的即时和长期影响。本荟萃分析旨在评估重复经颅磁刺激(rTMS)和经颅直流电刺激(tDCS)对随机对照试验(RCT)中 AD 不同认知领域的治疗效果。

方法

在以下数据库中搜索了截至 2021 年 12 月之前发表的探讨 rTMS 和 tDCS 对 AD 不同认知领域治疗效果的研究:PubMed 和 Web of Science。我们使用 STATA 12.0 软件计算标准均数差(SMD)和 95%置信区间(CI)。

结果

本研究纳入了 16 项 rTMS 治疗 AD 的研究(包括 372 例接受 rTMS 治疗的 AD 患者和 310 例接受假 rTMS 治疗的患者)和 11 项 tDCS 治疗 AD 的研究(包括 152 例接受 tDCS 治疗的 AD 患者和 134 例接受假 tDCS 治疗的患者)。本研究结果显示,与假 rTMS 相比,rTMS 治疗 AD 患者具有更好的即时和长期认知功能改善效果(即时效应:SMD=2.07,95%CI=0.37 至 3.77,I2=97.8%,p<0.001;长期效应:SMD=5.04,95%CI=2.25 至 7.84,I2=97.8%,p<0.001)。本研究结果显示,rTMS 对注意力、执行功能、语言和记忆功能的即时和长期影响不显著。此外,本研究结果显示,tDCS 组与假 tDCS 组之间,tDCS 对认知功能、注意力、语言或记忆功能的即时或长期影响无显著差异。

结论

rTMS 是治疗 AD 患者认知功能的有效治疗技术,而 tDCS 对 AD 患者的认知功能无显著治疗作用。需要开展更多大规模研究来探索 NIBS 对 AD 各种认知功能的影响。

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